Thursday, October 14, 2010

How sexism leads to bad medical care.

Before I get into the whole fucked up medical care I experience, I wanted to give a short blurb on the personal front, if you're not interested in that skip ahead to the third paragraph

Sometimes all one needs is a little perspective. Sometimes its a little rest. Sometimes its a bit of both.

I'm visiting the middle of Canada right now, yep Can-tario is where I am at. Kitchner/Waterloo specifically. I'm visiting a dear friend who is giving me ton of TLC. I'm sleeping in, lying on the couch, drinking beer and wine, generally being a single childless women. Except I miss my boys, terribly. I ache for my child to come into my bed at 4 in the morning and steal my pillow. I miss Mr.SM's stupid jokes and funny smile. At the same time, I needed this time.

We're stepping back from the brink. Which is nice. Its not just a step back, but a good walk away. We have work to do. Neither of us communicated well these last few weeks. We've both been so caught up in our own hurt, pain, stress that we have not been able to be there for each other. Mr. SM lost his grandfather. His grandfather wasn't just any man, he was the father figure in Mr.SM's life. He was the one who took him to all his games, talked to him about the 'why'. Why what Mr.SM did was wrong, not just telling him the actions were wrong. I lost the only grandfather that lived in the same country and city as me. My child lost his great grandfather.

Nor was it an easy loss. We had to choose not to give treatment. Which is a painful no win choice to make. But it sucks doubly when information that is needed to make the decision is not given freely. We often talk about how sexism in any profession hurts other in the profession. Rarely do we talk about how it hurts the by standers. I am an educated intelligent woman. Any one who is capable of being rational, analysis of information would have been able to understand our grandfathers condition if they were given the information. When doctors are conscending, elitist, sexists assholes they withhold information make decision for us and ultimately cause more pain to their patients and the patients family.

When I arrived in the hospital I tried getting information on my grandfathers condition. I was shown X rays because as the elderly prick doctor stated "I had a spark of intelligence about me". I refrained from saying FUCK YOU asshole because I needed to put my GF first. All he told me was that my GF's bowels had burst and he needed surgery to survive. When I asked what type of surgery and the risk of surgery I was told that it was surgery or death. The type of surgery was not explained and I stupidly did not ask. I should've. I assumed (which was a mistake) that the surgery would be stitching of the torn bowels.

Six hours later, the surgeon came down. PO'd as all hell and was angry that we were doing the surgery. When I asked what my options were, I was told to "close the book" on our grandfather. Let me tell you that is not how you talk to the advocate. The surgeon explained that my grandfather could die on the table (always a risk at his age) and would be on a ventilator. I'm looking at him, thinking yes but he would be ALIVE??? He will heal and he will be fine. When I asked the internal medicine doctor, the one that thought I had the spark of intelligence, he said normally these types of surgeries have a 1% risk of death and with my grandfathers age and health it was about 20-30% more. 70% chance of LIFE? of course we would choose that.

Thankfully GF's general practioner came by and had my GF transferred to the main trauma centre. Once we got there, the amazing doctors actually explained what was happening. The surgery was not a stitch'em up and go surgery. It was major surgery, complete removal of the bowel and placement of a stoma so that my GF could poo into a bag that he would have empty out. Yes the surgery they do as a treatment for colitis. Shocking isn't it? Our grandfather was 81. How do you think he wouldve adjusted if he had the surgery and survived. Thats not an easy surgery for a 25 year old. I know, I've witnessed friends go through it, let alone some with my grandfathers heath problems. He suffering from arrhythmia. His heart rated was fluctuating from 96 bpm to 117 bpm, he had COPD. These are major warning signs against the use of anesthetist. Oh and yeah at this point, >12 hours later we found out our grandfather had a 10% chance of survival and what did we want to do? The doctors at the trauma centre were amazing. Kind and compassionate, taking time to explain treatment options, risks associated with each. They were honest and open about what was happening and they left the decision making power in our hands. They did not make the decision for us.

Why didn't this conversation happen at the hospital in my grandfathers town, not one that was >1 hour drive away from ALL our family. He could've been kept comfortable in a hospital he knew, where family could easily be around him, where his grandchildren could've been with him when he died. None of that happened because the asshole doctor didn't think I could handle, understand or need the information. Apparenlty his old white ass was better equipped to make decisions about whether we should / want to do surgery then my brown illiterate self. We should've been given all the information at 10 am in the morning at the first hospital, had the pro and cons of each treatment option, the risks associated etc. We should not have been told the information

I think we made the right decision for our grandfather. It was a shitty spot to be in though, his mental facilities were intact and he knew he was dying. And Mr.SM and I didn't know how to be there for each other. We're working on that. We've been hit with alot. Thankfully my comps went well and has been a turning point for us. Hopefully we can keep walking away from that brink. Next post will be a summary of my exam.

14 comments:

I am so sorry. I was there the two years before my grandparents both died, not working at the time as a SAHM, and I totally understand those decisions and information left out and anger and overwhelm and grief.

I'm very sorry for your loss. I've been an advocate for my mother - it's been a couple of years now and all ended well - but I can remember the overwhelming frustration when I didn't have enough information and the fury when painful decisions were made with poor information. I'm so sorry you had this experience and hope you and your family heal as you move through the grieving process.

MM/Post-doc - thank you for the well wishes. We are slowly healing from the whole ordeal. What I can't over is the overt BS I dealt with bc of my gender / age. The initial doctor could've saved us so much heartach, stress and confusion if he was open, honest and gave us the power to make the decisions. He didn't do that. He decided to do the surgery. Period. No explanations, no discussions.

The trauma hospital was much better and we recieved excellent care. Through no fault of theirs, they had to deal with our anger, frustration and confusion which resulted from the first hospital. That is not right

SM: I am so sorry for your loss and all of this that lead up to it. You're right, the first doctor should've explained it better - and given you (all of you) the chance to understand and make the decision.

I went through a similar thing with my grandmother. A doctor who told me, after I took him to another room not in front of my mother and her sister, that he needed to tell me what was going on. And then, when he looked at me and told me I was a young girl so maybe I wouldn't understand the importance of all what happened, I lost it. I told him I was a doctor and knew this and that and that he needed to understand that his behaviour was unexcusable.

He then proceeded to tell me that "since I was a doctor too he could tell me the things that my mother and aunt wouldn't get"... yeah... not the best way to do all of it. Not. at. all.

In the end, I could've never done that if I would've been around for the beginning of my grandmother's illness (I was living in country farfar away and wasn't told to come home earlier - family business) but in the end I grew up very quickly and was the one handling the rest of the funeral things and will and stuff like that.

You have my email if you want to vent or talk about feelings. I buried my then husband's father some years later and that was a breaking point for us. It's one of the hardest things, imho, to be the "other one" when the person you love is going through hard times and when they might not want to communicate and it's all hurt all around.

i hope you can get some love and biuld some strenght when you are away and that things are better for all of your family soon/later on. You're in my prayers and thoughts!

Not to sound trite and "church lady"-ish, because obviously it is still all very much with you, but it's in the past now. You did the best you could under the circumstances, however insulting and dehumanizing as they were for your grandfather and your family as a whole. You have the future to look forward to, and a warm house and a loving family to return to. Count your blessings and move forward, be it as it may bit by bit.

I am so sorry. It's incredibly frustrating to not be told things because of your age/gender. I've gotten furious with medical practitioners who do not explain things properly to my mother about her mother (my grandmother) and those aren't even about major medical decisions. So, it must be (approximately) 1000x more infuriating for major medical decisions.

On another note, I'm glad that you and Mr. SM have taken a step back from the brink. And I hope that you all are able to continue walking away from there. I'll continue to keep you all in my thoughts.

Ooooh, you touched one of my sore spots--doctors and other medical professionals who talk down to me like I'm 4 years old. It drives me crazy to put up with this during a routine medical exam; I can't even begin to imagine how much worse it would be when someone's life was on the line.

I am sorry about the fallout SM. These sorts of things always have repercussions on our healing. For me, what has worked, is starting with forgiveness. It doesn't mean forgetting what has happened, and its not for them that you're doing it, it's more for you. Have a little kindness for yourself.

I had the complete opposite experience. And I wonder if it was because the neurosurgeon knew that I was a postdoc and had graduated with a PhD in Genetics. The entire time I had been in the hospital, everyone (except a couple of nurses) treated me with such respect.

Glad to read that you and Mr. SM are doing better, but I am really sorry that your experience with your GF's care was so awful. I am glad that you found a good place, with good information in the end, but I agree with you that it is too bad he couldn't have stayed in the place that was close to his family.

i'm sorry and outraged on your behalf. while i've never experienced sexism in quite this awful a manner. i've been a lurker for a while, so i thought that maybe it was time for me to comment and express my condolences.

Chall - a lot of my anger / frustration is that I did not respond like you. Meek, obedient person took over. I wish to God that I didn't do that. I wish I had ripped the dr's a new one...but hindsight is 20/20.

Anon - this post wasn't about just me. Others are also being treated the same way, just look at Chall's comment. Sexism hurts not just women, they hurt whole families.

Amanda - thank youDrDrA - thank you

Cath - it was pretty bad, now i'm more mad at myself for not getting pissed. Though I"m not sure that would've helped the situation.

Bean-mom - thanks:)Unlikelygrad - I think the Rural hospitals are so much worse then the big city teaching ones.

GPD - you are so good to me:) The major trauma hospital was completely different. Honest, empowering and kind. A night and day difference. I think the fact that the first hospital is in a rural area is a major factor.

MicroXX - thanksGvsLSR - thank you for coming out of the shadows :) hopefully we'll read more from you.